帕金森病合并下呼吸道感染患者的病原菌分布及血清PCT、ESR变化

Distribution of pathogenic bacteria and changes of serum PCT and ESR levels in patients with parkinson′s disease complicated with lower respiratory tract infection

目的探讨帕金森病(PD)合并下呼吸道感染患者的病原菌分布及血清降钙素原(PCT)、红细胞沉降率(ESR)的变化情况。方法选取2014年1月-2019年6月琼海市人民医院PD患者60例,根据其是否发生下呼吸道感染,分为试验组(发生下呼吸道感染)(n=30)和对照组(未发生下呼吸道感染)(n=30)。采用全自动微生物分析系统检测病原菌分布;采用ELISA法检测血清PCT,采用全自动血细胞分析仪检测ESR;收集患者临床资料,分析下呼吸道感染的影响因素。结果 30例PD合并下呼吸道感染的痰标本中,共检测出157株病原菌,以革兰阴性杆菌最多占66.24%,其次是革兰阳性菌占18.47%,真菌最少(15.29%)。试验组患者血清PCT、ESR水平显著高于对照组,差异有统计学意义(P<0.05)。年龄、合并其他慢性疾病、住院时间、侵入性操作、抗生素、住院环境、呼吸机辅助通气是PD合并下呼吸道感染的独立影响因素(P<0.05)。结论 PD合并下呼吸道感染患者的病原菌主要以革兰阴性杆菌为主,其血清PCT、ESR水平显著升高,可根据其病原菌分布、PCT及ESR水平变化情况和影响因素进行临床预防和治疗。

Objective To investigate the distribution of pathogenic bacteria and the changes of serum procalcitonin(PCT)and erythrocyte sedimentation rate(ESR) levels in patients with parkinson’ s disease(PD) and lower respiratory tract infection.Methods From January 2014 to June 2019,60 patients with PD in our hospital were divided into experimental group(n=30) and control group(n=30).The distribution of pathogenic bacteria was detected by automatic microbial analysis system;serum PCT was detected by ELISA;ESR was detected by automatic hematology analyzer,and the clinical data of patients were collected to analyze the influencing factors of lower respiratory tract infection.Results 157 strains of pathogenic bacteria were detected in 30 sputum samples.Gram negative bacilli(66.24%) were the dominant pathogen,followed by gram positive bacilli(18.47%) and fungi(15.29%).The levels of serum PCT and ESR in the experimental group were significantly higher than those in the control group(P<0.05).Age,combined with other chronic diseases,length of stay,invasive operation,antibiotics,hospitalization environment and ventilator-assisted ventilation were independent factors(P<0.05).Conclusions The main pathogens of PD patients with lower respiratory tract infection were gram-negative bacilli,and their serum PCT and ESR levels were significantly increased.Therefore,clinical prevention and treatment should be carried out according to the distribution of pathogens,changes of PCT and ESR levels and the influencing factors.